"Free Blank Medical Malpractice Release to Hold Harmless Agreement Form"
Request for Bid: S06CD009 Page 1 of OFFEROR: Purchasing Services BP Request for Bid-12.doc Form Date: 07/10/05 Informal Faxed Offer or electronic Offer shall be accepted. Fax number is 928-523- Request For Bid 1343. Follow with original written offer. Formal Sealed Faxed Offer or electronic Offer shall not be accepted. Offer shall be in a Request For Bid sealed envelope with Offeror’s name and Request For Bid number clearly marked on front. Send Sealed Director of Procurement, Purchasing Services, Northern Arizona University, Building Request For Bids to: 47A, Box 4124, S San Francisco St & Runke Dr, Flagstaff, AZ 86011-4124 Offers shall be submitted as a document set containing one (1) clearly marked original and one (1) electronic copy on CD Rom. Date Due: May 25, 2006 Time Due: 3:00 P.M., Arizona Local Time Responsible Buyer: Carol Luckey Phone: 928-523-6091 E-mail: Carol.Luckey@nau.edu Northern Arizona University is soliciting sealed Offers from qualified firms or individuals for the provision of Life Fitness Exercise Equipment in accordance with requirements, specifications, and terms and conditions cited herein and/or attached hereto. The undersigned certifies that to the best of his/her knowledge: Check one---------------------------------------------------------------- There is no officer or employee of Northern Arizona University who has, or whose relative has, a substantial interest in any contract award subsequent to this Request For Bid. Any and all public officers or employees of Northern Arizona University who have, or whose relative has, a substantial interest in any contract award subsequent to this Request For Bid are identified by name as part of the submittal. The undersigned further certifies that their firm (check one) Is or Is not currently debarred, suspended, or proposed for debarment by any federal entity. The Undersigned agrees to notify the University of any change in this status, should one occur, until such time as an award has been made under this procurement action. The undersigned agrees that this is a firm Offer, which shall be irrevocable and open for acceptance for calendar days (60 calendar days unless otherwise specified) from the date set for submission of Offer. Company Name: Date: Phone: Signature of Printed Name of Company Company Representative Representative E-mail Address THIS IS NOT AN ORDER – THE UNIVERSITY RESERVES THE RIGHT TO REJECT ANY AND ALL OFFERS Request for Bid: S06CD009 Page 2 of LINE QUANTITY UNIT DESCRIPTION UNIT PRICE AMOUNT NAU RESIDENCE LIFE (3 HALLS) 001 6 EACH LIFE FITNESS 90R LIFECYCLE REC BIKE 002 4 EACH LIFE FITNESS 90S STAIRCLIMBER 003 8 EACH LIFE FITNESS 93X TOTAL BODY CROSS-TRAINER NAU REC CENTER 004 4 EACH LIFE FITNESS 95Xi TOTAL BODY CROSS-TRAINER W/HR 005 1 EACH LIFE FIT 9500HR CPO LIFECYCLE UPRIGHT W/HR “BELT DRIVE” 006 1 EACH LIFE FIT CPO 9500RHR RECUMBENT BIKE NO SUBSTITUTIONS ALLOWED. MATCHING EXISTING EQUIPMENT. TOTAL PRICING FOR DELIVERY TO DOCK ONLY: TOTAL PRICING FOR DELIVERY AND INSTALLATION: Request for Bid: Page of LINE QUANTITY UNIT DESCRIPTION UNIT PRICE AMOUNT Sales Tax Rate (%) when applicable: % F.O.B. DESTINATION, NO FREIGHT ALLOWED Terms: Northern Arizona University, FLAGSTAFF, ARIZONA 86011 Shipment shall be made days after receipt of the order Total: Request for Bid: S06CD009 Page 3 of 1 If responding by express mail, allow sufficient time for on-campus delivery. Federal Express and Airborne Express deliver directly to Purchasing Services. UPS and United States Mail deliver to a central location on-campus and additional time shall be required for delivery to Purchasing Services. 2 Offeror shall provide current price list for each item offered. Offeror shall provide discount off list price. 3 Offeror shall describe, in detail, other value-added services available to the University but not necessarily addressed. Offeror may offer goods and/or services. The University shall determine which value-added service options shall be most beneficial from both a cost and service standpoint, and may further negotiate these options to include or omit dependent on the needs of the University. 4 No substitutions allowed. The requested product and/or service is an integral part, service or accessory that shall be compatible with existing equipment. 5 The initial term of a resulting Contract shall be one (1) year, from date of award, with an option to renew four (4) additional one- (1) year periods with a total term not to exceed five (5) years. 6 Should any discrepancies be found in or omissions from the specifications, or doubt as to their meaning, Offeror shall at once notify the University in writing. The University shall issue written instructions or addenda, as required, to all Offerors. The University shall not be responsible for any/all oral interpretations. 7 The University shall not guarantee any minimum purchase volumes of any kind including, but not limited to: equipment, parts, supplies, and/or services, under any resulting Contract. 8 Offeror shall acquire and maintain, at their sole expense, all necessary parking permits required by the University. Parking permits along with regulations governing traffic and parking are available from University Parking and Shuttle Services (928-523-6623) located at 113 W Dupont Ave., Flagstaff, AZ 86011. Permit applications and vehicle registration may also be accessed on-line at http://www.nau.edu/parking. Regulations shall be applicable to all employees of Offeror and shall be strictly enforced. All fines incurred shall be the sole responsibility of the Offeror. 9 Offeror shall acquire and maintain all necessary permits and licenses and shall adhere strictly to all Federal, State, County, or City laws, codes, regulations, and ordinances as applicable. Although this Request For Bid shall be primarily for the University, Offeror(s) acknowledge and agree that the prices offered to the University shall also be offered to these additional agencies should they elect to purchase off a resulting Contract. Each agency shall be responsible for ordering and payment of each order placed though this cooperative purchasing Contract. a. COOPERATIVE PURCHASING GROUP A: Northern Arizona University, Coconino County Community College, Arizona Western College, Yavapai Community College, and Eastern Arizona College have implemented an Intergovernmental Agreement which allows one agency to competitively bid goods and/or services and all agencies may purchase goods and/or services from any Contract resulting from this Request For Bid. b. COOPERATIVE PURCHASING GROUP B: Northern Arizona University, Arizona State University, and the University of Arizona are all state universities governed by the Arizona Board of Regents. Unless reasonable objection is made in writing as part of the Offer, the Board or either of the other two Universities’ may purchase goods and/or services from any Contract resulting from this Request For Bid. c. COOPERATIVE PURCHASING GROUP C: Northern Arizona University, City of Flagstaff, Flagstaff Unified School District #1, Coconino County, and Coconino County Community College have implemented an Intergovernmental Agreement which allows one agency to competitively bid goods and/or services and all agencies may purchase goods and/or services from any Contract resulting from this Request For Bid. Request for Bid: S06CD009 Page 4 of Attachment A - TERMS AND CONDITIONS 1. Remedies and Applicable Law. This Contract shall be governed by and construed in accordance with the laws of the State of Arizona. The University and Offeror shall have all remedies afforded by said law. 2. Interpretation-Parol Evidence. This writing shall be intended by the parties as a final expression of their Contract and shall be intended also as a complete and exclusive statement of the terms of their Contract. No course of prior dealings between the parties and no usage of the trade shall be relevant to supplement or explain any term used in this Contract. Acceptance or acquiescence in a course of performance rendered under this Contract shall not be relevant to determine the meaning of this Contract even though the accepting or acquiescing party has knowledge of the nature of the performance and opportunity for objection. Whenever a term defined by the Uniform Commercial Code is used in this Contract, the definition contained in the Code is to control. 3. Contract Claims and Controversies. All contract claims and controversies arising under this Contract shall be resolved pursuant to Arizona Board of Regents procurement procedures, section 3-809, in particular section 3-809C. 4. Equal Opportunity Clause. The provisions of Section 202 Executive Order 11246.41, C.F.R. §60-1.4.41, C.F.R. §60-250.4 and 41, and C.F.R. §60-741.4 shall be incorporated herein by reference and shall be applicable to this Contract unless this Contract is exempted under the rules, regulations, or orders of the Secretary of Labor. 5. Non-Discrimination. During the performance of this Contract, the Offeror agrees not to discriminate against any employee or applicant for employment because of race, color, sex, religion, or national origin, or because he or she has a physical or mental handicap, or because he or she is a disabled veteran or a veteran of the Vietnam era. The aforesaid provision shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training including apprenticeship. The parties agree to comply with Arizona Executive Order 99-4, prohibiting discrimination in employment by government contractors, to the extent applicable to this Contract. 6. Indemnification. Offeror shall indemnify, defend, save and hold harmless the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees (hereinafter referred to as “Indemnitee”) from and against any and all claims, actions, liabilities, damages, losses, or expenses (including court costs, attorneys’ fees, and costs of claim processing, investigation and litigation) (hereinafter referred to as “Claims”) for bodily injury or personal injury (including death), or loss or damage to tangible or intangible property caused, or alleged to be caused, in whole or in part, by the negligent or willful acts or omissions of Offeror or any of its owners, officers, directors, agents, employees or subcontractors. This indemnity includes any claim or amount arising out of or recovered under the Workers’ Compensation Law or arising out of the failure of such Offeror to conform to any federal, state or local law, statute, ordinance, rule, regulation or court decree. It is the specific intention of the parties that the Indemnitee shall, in all instances, except for Claims arising solely from the negligent or willful acts or omissions of the Indemnitee, be indemnified by Offeror from and against any and all claims. It is agreed that Offeror shall be responsible for primary loss investigation, defense and judgment costs where this indemnification is applicable. In consideration of the award of this contract, the Offeror agrees to waive all rights of subrogation against the State of Arizona, its officers, officials, agents and employees for losses arising from services performed by the Offeror for the State of Arizona. 7. Labor Disputes. Offeror shall give prompt notice to the University of any actual or potential labor dispute which delays or may delay performance of this Contract. Request for Bid: S06CD009 Page 5 of 8. Force Majeure. Neither party shall be held responsible for any losses resulting if the fulfillment of any terms or provisions of this Contract are delayed or prevented by any cause not within the control of the party whose performance is interfered with, and which by the exercise of reasonable diligence, said party is unable to prevent. 9. No Waiver. No waiver by the University of any breach of the provisions of this Contract by the Offeror shall in any way be construed to be a waiver of any future breach or bar the University's right to insist on strict performance of the provisions of the Contract 10. Modifications. This Contract shall be modified or rescinded only by a writing signed by both parties or their duly authorized agents. 11. Assignment-Delegation. No right or interest in this Contract shall be assigned or delegation of any obligation made by Offeror without the written permission of the University. Any attempted assignment or delegation by Offeror shall be wholly void and totally ineffective for all purposes unless made in conformity with this paragraph. 12. Assignment of Anti-Trust Overcharge Claims. The parties recognize that in actual economic practice overcharges resulting from anti-trust violations are in fact borne by the ultimate purchaser; therefore, Offeror hereby assigns to the Arizona Board of Regents any and all claims for such overcharges. 13. Cancellation for Lack of Funding. This Contract may be canceled without any further obligation on the part of the Arizona Board of Regents and Northern Arizona University in the event that sufficient appropriated funding is unavailable to assure full performance of the terms. The Offeror shall be notified in writing of such non-appropriation at the earliest opportunity. 14. Cancellation of State Contract. In accordance with A.R.S. §38-511, this Contract may be canceled without penalty or further obligation if any person significantly involved in initiating, negotiating, securing, drafting, or creating the Contract on behalf of the University shall, at anytime while the Contract or any extension of the Contract shall be in effect, be an employee of any other party to the Contract in any capacity or a consultant to any other party of the Contract with respect to the subject matter of the Contract. 15. Cancellation for Conflict of Interest. The parties agree that this Contract may be canceled for conflict of interest in accordance with A.R.S. §38-511. 16. Termination. The University may by written notice, stating the extent and effective date, terminate this Contract for convenience in whole or in part, at any time. The University shall pay the Offeror as full compensation for performance until such termination: (1) the unit or pro rata Contract price for the delivered and accepted portion; and (2) a reasonable amount, not otherwise recoverable from other sources by the Offeror as approved by the University, with respect to the undelivered or unacceptable portion of this Contract, provided compensation hereunder shall in no event exceed the total Contract price. 17. Termination for Default. In the event that the Offeror shall fail to maintain or keep in force any of the terms and conditions of this Contract, the University may notify the Offeror in writing of such failure and demand that the same be remedied within ten (10) days. Should the Offeror fail to remedy the same within said period, the University shall then have the right to terminate this Contract. 18. Insolvency. The University shall have the right to terminate this Contract at any time in the event the Offeror files a petition in bankruptcy, or is adjudicated bankrupt; or if a petition in bankruptcy is filed against the Offeror and not discharged within thirty (30) days; or if the Offeror becomes insolvent or makes an assignment for the benefit of its creditors or an arrangement pursuant to any bankruptcy law; or if a receiver is appointed for the Offeror or its business. Request for Bid: S06CD009 Page 6 of 19. Anti-Kickback. In compliance with FAR 52.203-7, the University has in place and follows procedures designed to prevent and detect violations of the Anti-Kickback Act of 1986 in its operation and direct business relationships. 20. Gratuities. The University may, by written notice to the Offeror, cancel this Contract if it is found by the University that gratuities, in the form of entertainment, gifts or otherwise, were offered or given by the Offeror, or any agent or representative of the Offeror, to any officer or employee of the State of Arizona with a view toward securing a Contract or securing favorable treatment with respect to the awarding or amending, or the making of any determinations with respect to the performing of such Contract. In the event this Contract is canceled by the University pursuant to this provision, the University shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by Offeror in providing such gratuities 21. Inspection and Audit. All books, accounts, reports, files, and other records relating to this Contract shall be subject at all reasonable times to inspection and audit by the Arizona Board of Regents, Northern Arizona University, or the Auditor General of the State of Arizona, or their agents for five (5) years after completion of this Contract. Such records shall be produced at Northern Arizona University, or such other location as designated by Northern Arizona University, upon reasonable notice to the contracting party. 22. Insurance Requirements. Without limiting any liabilities or any other obligations of Offeror, Offeror shall provide and maintain the minimum insurance coverage listed below unless otherwise agreed to in writing. Coverage shall be provided with forms and insurers acceptable to the University, until all obligations under the Contract shall be satisfied. An acceptable insurance company shall be authorized to conduct business in the State of Arizona and shall be rated at least A-,VII by A.M. Best, Inc. A. If applicable, Worker's Compensation insurance coverage for all employees which meets Arizona statutory benefits; including Employer’s Liability with minimum limits of $500,000 each accident, $500,000 each employee/disease, and $1,000,000 policy limits/disease. The University shall not require an additional insured endorsement, however, the policy shall include an endorsement for All State coverage for the State of Arizona. If designated as a Sole Proprietor with no employees, the State of Arizona (ARS 23-901, ARS 23-961a) requires submittal of a written Sole Proprietor Waiver. The waiver document is Form #spw/1 and can found at http://www.azrisk.state.az.us/Forms/sole_prop.pdf. B. Comprehensive General Liability insurance with a minimum combined single limit (CSL) each occurrence of ONE MILLION DOLLARS ($1,000,000) and TWO MILLION DOLLARS ($2,000,000) general aggregate. The policy shall include coverage for bodily injury, broad form property damage (including completed operations), personal injury (including coverage for contractual and employee acts), blank contractual liability, products, and completed operations, this coverage shall extend for year one past acceptance, cancellation, or termination of the services or work defined in the Contract; Fire Legal Liability; Liquor Liability (if applicable). C. Comprehensive Automobile Liability insurance with a combined single limit (CSL) for bodily injury, death, or property damage of not less than ONE MILLION DOLLARS ($1,000,000) with respect to “any auto” or Offeror’s “scheduled, owned, hired, or non-owned vehicles,” assigned to or used in performance of the Services. Request for Bid: S06CD009 Page 7 of D. If applicable, Professional Liability with minimum limits of ONE MILLION DOLLARS ($1,000,000) each claim (or each wrongful act), and THREE MILLION DOLLARS ($3,000,000) aggregate with a retroactive liability date (if applicable to claims-made coverage) the same as the effective date of the Contract. The policy shall cover professional misconduct or lack of ordinary skill for those positions defined in the Scope of Work of the Contract and, at the discretion of the State of Arizona, the Arizona Board of Regents, and Northern Arizona University, shall include one of the following types of Professional Liability policies: Directors or Officers, Errors and Omissions, Medical Malpractice, Druggists Professional, Architects/ Engineers Professional, Lawyers Professional, Teachers Professional, Accountants Professional, and Other (specify professions from Scope of Work). The policy shall contain an Extended Claim Reporting Provision of not less than one year following termination of the policy. E. If applicable, Builder’s Risk coverage in an amount that represents the project’s estimated completed value. F. The policies required by (B), (C), (D), and (E) herein shall be endorsed to include the State of Arizona, the Arizona Board of Regents, and Northern Arizona University as additional insured. G. The policies required by (B), (C), (D), and (E) shall stipulate that the insurance afforded Offeror shall be primary insurance and that any insurance carried by the State of Arizona, the Arizona Board of Regents, and Northern Arizona University, shall be excess and not contributory insurance to that provided by the named insured. H. Coverage afforded under these policies shall not be canceled, terminated, or materially altered until thirty (30) days prior written notice has been given to the University. I. A certificate of insurance acceptable to the University shall be issued to the University as evidence that policies providing the required coverage’s, conditions and limits are in full force and effect. An acceptable certificate shall include statements indicating compliance with the requirements of (F), (G), and (H), a statement describing the Offeror’s activity/property/Contract with Northern Arizona University, shall be countersigned by an authorized representative of the issuing insurance company, and list Northern Arizona University as the certificate holder. J. Offeror shall provide the University with an acceptable Certificate of Insurance prior to the commencement of providing the goods/services defined in the Contract. K. Failure on the part of Offeror to meet these requirements shall constitute a material breach upon which the State of Arizona, the Arizona Board of Regents, and the University may immediately terminate the Contract, or, at its discretion, procure or renew such insurance and pay any and all premiums in connection therewith, and all monies so paid by the State of Arizona, the Arizona Board of Regents, and the University shall be repaid by Offeror to the University upon demand, or the State of Arizona, the Arizona Board of Regents, and the University may offset the cost of the premiums against any monies due to Offeror L. Costs for coverage’s broader than those required or for limits in excess of those required shall not be charged to the State of Arizona, the Arizona Board of Regents, and Northern Arizona University. M. The University reserves the right to request and receive certified copies of any or all of the above policies and/or endorsements within ten (10) calendar days of Contract signature. N. The Offeror and its insurers providing the required coverage’s shall waive all rights of recovery against the State of Arizona, the Arizona Board of Regents, and the University, their agents, officials, and employees. Request for Bid: S06CD009 Page 8 of O. The Certificate of Insurance shall be mailed to: Northern Arizona University Purchasing Services RE: S06CD009 Box 4124 Flagstaff, AZ 86011 23. Asbestos Notification and Confirmation. All buildings on the campus of Northern Arizona University have been tested by a certified testing agency to determine the presence of asbestos containing building materials (ACBM’s) and presumed asbestos containing materials (PACM’s). The test confirms the presence of ACBM’s in several campus buildings. The test results are documented and on file with the University’s Environmental Health and Safety Department and shall be available for review by contacting Gerald Bacon, Asbestos Program Coordinator, at 928-523-6435. Renovation/Construction/Removal and/or Installation services that may impact/disturb asbestos containing building materials (ACBM’s) or presumed asbestos containing materials (PACM’s) shall require Offeror to complete, sign, and submit to the University Form FS#13: Contractor Notification and Confirmation for Asbestos Containing Building Materials (refer to Attachment B). No work shall commence prior to Offeror receiving an Asbestos Survey Results and Work Authorization with appropriate University signatures. 24. Package Goods. Offeror shall package goods in accordance with good commercial practice. Each shipping container shall be clearly and permanently marked as follows: (a) Offeror's name and address; (b) University’s name, address and purchase order number; (c) Container number and total number of containers, e.g., box 1 of 4 boxes; and (d) The number of the container bearing the packing slip. Offeror shall bear cost of packaging unless otherwise provided. 25. Shipment Under Reservation Prohibited. Offeror shall not be authorized to ship the goods under reservation and no tender of a bill of lading shall operate as a tender of the goods. 26. Liens. All goods delivered and labor performed under this Contract shall be free of all liens and, if the University requests, a formal release of all liens shall be delivered to the University. 27. No Replacement of Defective Tender. Every tender of goods shall fully comply with all provisions of this Contract as to time of delivery, quantity, quality, and the like. If a tender is made which does not fully conform, this shall constitute a breach and Offeror shall not have the right to substitute a conforming tender. 28. Title And Risk Of Loss. The title and risk of loss of the goods shall not pass to the University until the University actually receives the goods at the point(s) of delivery. Prices shall be F.O.B. Destination. Offeror shall retain title and control of all goods until they are delivered, received, and the Contract of coverage has been completed. All risk of transportation and all related charges shall be the responsibility of the Offeror. The Offeror shall file all claims for visible and concealed damage. The University shall notify the Offeror promptly of any damaged goods and shall assist the Offeror in arranging for inspection. Notice of rejection may be made to the Offeror at any time within one month after delivery has been made. When supported by a written statement from the University, the Offeror shall not dispute its claims of damage. 29. Right of Inspection. The University shall have the right to inspect the goods at delivery before accepting them. 30. Warranties. In addition to any implied warranties, Offeror warrants that the goods furnished shall conform to the specifications, drawings, and descriptions listed herein, and to the sample or samples furnished by the Offeror, if any. In the event of a conflict between the specifications, drawings, and description, the specifications shall govern. Request for Bid: S06CD009 Page 9 of 31. Sales and Use Tax. The Offeror shall comply with and require all of his subcontractors to comply with all the provisions of the applicable state and sales excise tax law and compensation use tax law and all amendments to same. The Offeror further agrees to indemnify and save harmless the University, of and from any and all claims and demands made against it by virtue of the failure of the Offeror or any subcontractor to comply with the provisions of any or all said laws in amendments. The University is not exempt from state sales excise tax and compensation use tax. 32. Furnish and Install. The items in this Contract shall be provided on an Offeror furnish and install basis. Offeror shall have complete responsibility for the items or products until they are in place and working. Any special installation preparation and requirements shall be submitted to the University. All transportation and coordination arrangements shall be the responsibility of the Offeror. Delivery of products shall be coordinated so that products shall be delivered direct to the installation site. This shall minimize the risk of loss and/or damage and shall avoid double handling. 33. Changes. Within the limits allowed by law, Offeror agrees that the University may order additional services, or make changes by altering, adding to, or deducting from the proposed services, the Contract sum being adjusted accordingly, and Offeror shall enter into a modification of the Contract to reflect said changes. 34. Installment Payment Contract. The University is precluded from entering into an installment Contract unless such Contract can be canceled for non-allocation of funds at the end of any fiscal year, at no penalty to the University. If funds shall not be allocated for this Contract for periodic payment in any future annual fiscal period, following the University’s formal request for funds, the University shall not be obligated to pay the net remainder of agreed to consecutive periodic payments remaining unpaid beyond the end of the then current fiscal year. The University agrees to notify the Offeror of such non-allocation at the earliest possible time. No penalty shall accrue to the University in the event this provision shall be exercised. This provision shall not be construed so as to permit the University to terminate this Contract in order to acquire similar goods and/or services from another party. 35. Price Adjustment. Price changes shall only be considered at the end of one Contract period and the beginning of another. Price change requests shall be supported by evidence of increased costs to the Offeror. The University shall not approve price increases that shall merely increase the gross profitability of the Offeror at the expense of the University. Price change requests shall be a factor in the Contract extension review process. The University shall determine whether the requested price increase or an alternate option shall be in the best interest of the University. 36. Fixed Escalation Clause. Offeror shall certify a fixed maximum percentage of escalation of costs of goods and/or services for a period of five (5) years following expiration of warranty. Cost shall not exceed five (5) % per year or Consumer Price Index (CPI), whichsoever is less. 37. Liquidated Damages: The University and the Offeror agree that in the event that the Offeror fails to perform under this Contract, the University shall be damaged. The extent of the damage is very difficult to calculate. Therefore, the Offeror agrees to pay the University liquidated damages if the agreed upon delivery and installation dates shall not be met. The liquidated damages shall be 5% of the total Contract price per day after the agreed upon completion date, not to exceed a total of 100% of the total Contract price. 38. Invoices. Invoices covering each delivery shall be mailed to Accounts Payable once a month. Invoices shall be for all items delivered within the month. The intent shall be to receive one monthly billing. All invoices shall reference the purchase order number and the Contract. 39. Payment. Payment shall be subject to the provisions of Title 35 of Arizona Revised Statutes relating to time and manner of submission of claims. The University's obligation shall be payable only and solely from funds appropriated for the purpose of the Contract. 40. Personnel. Employees of the Offeror assigned to the project and identified by name in the Contract shall remain dedicated to this project. Personnel changes shall be permitted only with prior notification and approval of the University. Request for Bid: S06CD009 Page 10 of 41. Independent Contractor. It shall be understood that Offeror shall operate as an independent contractor, not as an employee or agent of the University. 42. Advertising/Publishing. Offeror shall not advertise or publish, without the University’s prior consent, the fact that the University had entered into this Contract, except to the extent necessary to comply with proper request for information provided by appropriate statutes. Request for Bid: Page of Attachment B NORTHERN ARIZONA UNIVERSITY FORM FS-13 CONTRACTOR NOTIFICATION AND CONFIRMATION FOR ASBESTOS CONTAINING BUILDING MATERIALS ON THE NAU CAMPUS PROJECT NAME: NAU PROJECT#: The following is notification and confirmation for all Contractors and Subcontractors working at the Northern Arizona University campus. A comprehensive asbestos containing building material (ACBM) survey was completed July 2000 and is available for review in the Office of NAU Department of Environmental Health & Safety in accordance with the Occupational Safety and Health Administration (OSHA) Asbestos Standard 29 CFR 1926.1101. The following ACBM’s and assumed ACBM’s* have been identified to be present in the area of this project in the ceiling, walls, flooring of the: NAU is responsible for informing you of the presence of ACBM’s in your project work area on the NAU campus. This document acts as the vehicle of notifying you of ACBM’s present. If ACBM’s are found or suspected, stop all work immediately and contact the NAU Project Manager, or if unavailable, Risk Management. By law, Contractors must provide training for their employees who will be working with or near ACBM’s. It is the Contractor’s responsibility to be knowledgeable of, and comply with, all applicable local, state, and federal laws. The signature below acknowledges that you received this information and will comply with this document and all legal requirements. If you have any questions, please contact Gerald V. Bacon Asbestos Project Manager at 928-523-6435. Company Name: Name of Responsible Party: Title: Signature: Date: Submit signed form with Offer. Failure to include this form shall be considered non-responsive. Bid/Proposal Acknowledgement Receipt PURCHASING SERVICES REQUEST FOR BID/PROPOSAL DESCRIPTION: LIFE FITNESS EXERCISE EQUIPMENT REQUEST FOR BID/PROPOSAL NUMBER: S06CD009 Offerors that access Request for Bids or Proposals from the Purchasing Services web pages and who wish to make a submittal shall fill-in, sign and submit this document to Purchasing Services. Fax the completed and signed document to Purchasing Services at 928-523-1343. Only those firms returning this completed form shall receive addenda, which may be issued prior to the due date and time of the above noted Offer. This document was created in MS Word 2000. The grayed fields can be tabbed through, using Shift + Tab to reverse direction. Name of Firm Name of Contact Title of Contact Address 1 Address 2 City State Zip Code - Telephone Number Fax Number ( ) - ( ) - E-mail address, if available Print Name of Firm’s Authorized Agent Signature of Firm’s Authorized Agent Title of Signatory Date To print this form specify in Print… page range, Pages: 1 VENDOR INFORMATION Purchasing Services Substitute W-9 FEIN: OR SSN: - - REMIT ADDRESS PURCHASE ORDER ADDRESS (If different than order address) Name Address Line 1 Address Line 2 City State Zip plus four Contact name Phone number Fax Number Arizona Tax License Number: Organization Structure (Limit selection to one type) Individual/Sole Proprietor Corporation Government Agency Non-Profit Agency Partnership Public Utility Small business/Minority Business Ownership: (Limit selection to one type) Non-Small/Non- Small Business/Woman Disabled-Minority Women Owned Business Minority/Non-Disabled Owned Owned Business Owned by Disabled Small Business (Per ARS § Small Business/Disabled Disabled-Woman Individual (Per ARS § 41- 41-1001.19) Owner Owned Business 14925.5)) Disabled-Minority- Minority Owned Business Small Business/Minority Minority-Woman Owned Woman Owned (Per 15 CFR 1400.2(a)) Owned Business business Small Business/Minority- Small Business/Disabled- Small Business/Disabled- Woman Owned Minority Owned Minority-Woman Owned Applicant Certification, under penalties of perjury, I certify that: a. THE NUMBER SHOWN ON THIS FORM IS MY CORRECT TAXPAYER IDENTIFICATION NUMBER. b. I AM NOT SUBJECT TO BACKUP WITHHOLDING. c. I AM A U.S. PERSON. Signature: Name: _________________________________________ ____________________________________________ Date: Title: __________________________________________ ___________________________________________ Northern Arizona University is an Equal Opportunity/Affirmative Action Institution